Common Written Examination for Recruitment of Clerks - (CWE - Clerks-III)

Registration # : 1250123097

Full Name :


Category : If Person with Disability : Type of Disability : Percentage of disability :


Do you intend to use the services of a scribe NA (only for VI and OC whose writing speed is affected by cerebral palsy) ? : Whether are you a Children/Family Members of those who died in 1984 Riots? : Whether domiciled in Kashmir Division of the State of J&K during the period 1-1-1980 to 31-12-1989 ? : Do you belong to a Religious Minority Community? : Religion : Are you an Ex-Serviceman? : Are you a Disabled Ex-Serviceman (DISXS)? : Have you joined a Government job on the civil side after availing of the benefits given as an ex-serviceman?: Are you a Dependent of Serviceman killed in Action (DXS) ? : Are you seeking relaxation under widow / divorced women / women judicially Separated from their husbands and who are not re-married?: Whether Regular Employees of the Union Carbide Factory, Bhopal, retrenched from service (applicable to Madhya Pradesh state only)? : Have you applied for the CWE for Clerical Cadre held in November/ December 2011? : Have you applied for the CWE for Clerical Cadre held in December 2012? : Nationality / Citizenship : State/ UT applied for: State code : Centre of Examination : Personal Details : First Name : GARA NO NO NO NO NO Indian Andhra Pradesh 12 Vishakhapatnam NO NO NO Hindu NO NO

Canara Bank 2.Indian Bank .10 Class / Grade Second Class 9676345612 venky77777@gmail.2013 : Gender : Husband's Name : Father's Name : Mother's Name : Address for correspondence : VENKATESH 14-08-1990 22 MALE GARA TAVITAYYA GARA RAJULAMMA DRNO 2-17 MAINSTREET KANCHILI MANDAL MANDAPALLI VILLAGE RUSHIKUDDA POST District : State : Pin code : Permanent Address : SRIKAKULAM ANDHRA PRADESH 532292 DRNO 2-17 MAINSTREET KANCHILI MANDAL MANDAPALLI VILLAGE RUSHIKUDDA POST District State : Pin code : Contact Details : Phone No. : Email ID : Educational Qualification (as on 01. : Mobile No.com SRIKAKULAM ANDHRA PRADESH 532292 Do you have Operating and working knowledge in computer systems : Details of Computer Knowledge : Do you have work experience? : Other Details : Whether desirous of taking Pre-Exam Training (Only for SC/ST/Religious Minority Communities/Ex-Servicemen/PWD): If Yes.Andhra Bank 3.2013) : Exam Passed Graduation / Equivalent : Degree B.2/4 Middle Name : Last Name : Date of Birth : Age completed as on 01. Centre for Training : Details of Preference : NA 1.08.08.Tech Subject /Stream Engineering YES Studied Computer/IT as a Subject in High School/College/Institute IT as a subject NO Date of Passing 23-04-2013 % of Marks 57.

United Bank of India 13. Place: .Bank of Baroda 8.Bank of India 5.Punjab National Bank 17.Oriental Bank of Commerce 12.Corporation Bank 16. my candidature is liable to be cancelled.Dena Bank 19.00 MSPD3083149101 22-08-2013 DECLARATION : I understand that in the event of any information being found untrue or incorrect at any stage/in the event any circumstances which may impair my fitness for employment in Banks/ organisation/ I do not satisfy any of the eligibility criteria stipulated.Allahabad Bank 15.Punjab & Sind Bank Whether any prosecution/ detention/ fine/conviction/ sentence against you has been awarded by any court of law for any offence? : If yes.Indian Overseas Bank 7.Vijaya Bank 18.Bank of Maharashtra 9.3/4 4.Union Bank of India 10.Syndicate Bank 11. particulars of the same : Languages Known : Languages Known TELUGU ENGLISH HINDI Read YES YES YES Write YES YES YES Speak YES YES NO NO Application Fee / Intimation charges : Payment In : Amount : Reference ID : Transaction Date : ONLINE 600.Central Bank of India 6.UCO Bank 14.

and Password emailed to you carefully for further reference NOTE: Please DO NOT SEND application printout to IBPS .4/4 Date: 22-08-2013 Signature of Applicant Please retain your Registration No.

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